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Oropouche virus disease - French Guiana, France

On 30 September 2020, the French Guiana Regional Health Agency (ARS) reported the first detection of Oropouche virus (OROV) in French Guiana. On 22 September 2020 the Pasteur Institute in Cayenne (a member of the French National Reference Laboratory for arboviruses) notified the France IHR National Focal Point of seven laboratory-confirmed cases of Oropouche virus infection in the village of Saül. These cases were identified following clinical investigations of an unusually high number of dengue-like illnesses in the village. Between 11 August and 25 September, there were 37 clinically-compatible cases of Oropouche virus disease identified in Saül. The results of serology for dengue, chikungunya, and Zika were negative, and seven of nine cases tested positive for OROV by reverse transcriptase polymerase chain reaction (RT-PCR).

Among the 37 clinically-compatible cases, most cases are male (60%) and the median age is 36 years (range 3-82 years). The most represented age range is 15 to 54-years-old (19 cases) followed by 0 to 14-years-old (10 cases). A peak of cases was observed in mid-September however, the outbreak investigation remains ongoing.

Monkeypox – Democratic Republic of the Congo

From 1 January through 13 September 2020, a total of 4,594 suspected cases of monkeypox, including 171 deaths (case fatality ratio 3.7%), have been reported in 127 health zones from 17 out of 26 provinces in the Democratic Republic of the Congo. The first epidemic peak was observed at the beginning of March 2020 (epi week 10), with 136 cases reported weekly (Figure1). From 1 January through 7 August, the Institut National de Recherche Biomédicale (INRB) received 80 samples from suspected cases of monkeypox, of which 39 samples were confirmed positive by polymerase chain reaction. Four out of the 80 specimens were skin lesions (crusts/vesicles), the remaining samples were blood. There is no further information at this time regarding the outcome of these 80 patients whose samples were tested. Confirmatory testing remains ongoing.

During the same period in 2019, 3,794 suspected cases and 73 deaths (CFR 1.9%) were reported in 120 health zones from 16 provinces while a total of 2,850 suspected cases (CFR 2.1%) were reported in 2018.

Chikungunya – Chad

On 28 August 2020, the National IHR Focal Point of Chad notified WHO of an outbreak of chikungunya in Abéché, eastern Chad.

Ebola virus disease – Democratic Republic of the Congo

Three months after the declaration of the eleventh Ebola virus disease (EVD) outbreak in Equateur Province, Democratic Republic of the Congo, the number of confirmed cases continues to increase, and the geographic spread of the outbreak continues to expand.

As of 1 September 2020, 110 cases (104 confirmed and six probable) including 47 deaths (case fatality ratio 43%) have been reported from 36 health areas in 11 health zones. In the past 21 days (12 August – 1 September 2020), 24 confirmed cases have been reported in 15 health areas across eight health zones. To date, three healthcare workers have been affected, making up 3% of all cases. In addition, 48 people have recovered from EVD to date.

Circulating vaccine-derived poliovirus type 2 – Sudan

On 9 August 2020, the Federal Ministry of Health, Sudan notified WHO of the detection of a

Yellow fever – French Guiana, France

On 23 July 2020, the France IHR National Focal Point reported a confirmed autochthonous (locally acquired) case of yellow fever in a 14-year-old male in French Guiana. On 17 July 2020, the case was laboratory confirmed at the French National Reference Centre for arboviruses, Institute Pasteur Cayenne.

The case-patient had severe disability, and developed dengue-like symptoms on 12 July. On 16 July, he was hospitalized in an intensive care unit in Cayenne, French Guiana, with consciousness disorders and acute liver failure, and died on 19 July.

Plague – Democratic Republic of the Congo

The health zone of Rethy in Ituri province, the Democratic Republic of the Congo, has seen an upsurge of plague cases since June 2020. The first case, a 12-year-old girl, reported to a local health centre on 12 June experiencing a headache, fever, cough, and an enlarged lymph node. She died on the same day and further deaths from the community due to suspected cases of plague were subsequently reported.

From 11 June though 15 July, six out of 22 health areas have been affected within Rethy health zone (11 villages), with a total of 45 cases including nine deaths (case fatality rate: 20%). All nine (9) cases who died presented with signs of headache, high fever, and painful nodes; four (4) out of the nine (9) cases had cough.

Influenza A(H1N2) variant virus – Brazil

On 22 June 2020, the International Health Regualtions (IHR) Focal Point (FP) of Brazil shared a preliminary report with the Panamerican Health Organization, the WHO Regional Office for the Americas of a human infection with Influenza A(H1N2) variant virus (A(H1N2)v). According to the report, the patient, a 22-year-old female, with no comorbidities, worked in a swine slaughterhouse in Ibiporã Municipality, Paraná State, and developed an influenza-like illness on 12 April 2020. The patient initially sought medical care on 14 April and a respiratory specimen was obtained on 16 April as part of routine surveillance activities. The patient was treated with oseltamivir, was not hospitalized and has recovered.

A real-time RT-PCR test conducted at the public health laboratory identified a non-subtypable influenza A virus. In May 2020, the specimen was forwarded to the Laboratory of Respiratory Virus and Measles, Oswaldo Cruz Institute (FIOCRUZ per its acronym in Portuguese), a national influenza reference laboratory, in Rio de Janeiro. On 22 June, genetic sequencing characterized this virus as an influenza A(H1N2)v virus.

Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia

Between 1 April and 31 May 2020, the National IHR Focal Point of Saudi Arabia reported nine new cases of MERS-CoV infection, including five deaths. The cases were reported from Riyadh (seven cases), Assir (one case) and Northern (one case) Regions. Most cases were and ages of the reported cases ranged from 40 to 96 years.

Of the cases reported in Riyadh six were from a hospital outbreak in the region between 21 and 31 May 2020: an index case who was a newly admitted patient, and five secondary cases identified through contact tracing. One of the secondary cases was a health care worker and the other four were in-patients admitted due to other health conditions. All four in-patients were bedridden and above 75 years of age. All reported cases had comorbidities with the exception of the healthcare worker.

Ebola virus disease – Democratic Republic of the Congo

On 25 June 2020, the Minister of Health of the Democratic Republic of the Congo declared the end of the Ebola Virus Disease (EVD) outbreak in North Kivu, Ituri and South Kivu Provinces . In accordance with WHO recommendations, the declaration was made more than 42 days after the last person who contracted EVD in this outbreak tested negative twice and was discharged from care.

The outbreak was declared on 1 August 2018 following investigations and laboratory confirmation of a cluster of EVD cases in North Kivu Province. Further investigations identified cases in Ituri and North Kivu Provinces with dates of symptom onset from May to August 2018. In 2019, the outbreak subsequently spread to South Kivu Province, and on 17 July 2019, the WHO Director-General declared the outbreak a Public Health Emergency of International Concern. In the Democratic Republic of the Congo, 11 outbreaks have been recorded since the first recognized outbreak in 1976. The 10th EVD outbreak in North Kivu, Ituri and South Kivu Provinces was the country's longest EVD outbreak and the second largest in the world after the 2014–2016 EVD outbreak in West Africa.

Ebola virus disease – Democratic Republic of the Congo

No new confirmed cases of Ebola virus disease (EVD) have been reported in Ituri, North Kivu and South Kivu Provinces of the Democratic Republic of the Congo since 27 April 2020 (Figure 1). While this is a positive development, there remains a risk of re-emergence of EVD. It is critical to maintain surveillance and response operations in the period leading up to the declaration of the end of the outbreak, as well as after the declaration – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak .

From 11 to 16 June 2020, an average of 2939 alerts were reported per day, of which 2788 (about 95%) were investigated within 24 hours. Of these, an average of 453 alerts were validated as suspected cases each day, requiring specialized care and laboratory testing to rule-out EVD. The number of reported and validated alerts has remained stable in recent weeks. Timely testing of suspected cases continues to be provided from eight laboratories. From 8 to 14 June 2020, 3219 samples were tested including 2513 blood samples from alive, suspected cases; 324 swabs from community deaths; and 382 samples from re-tested patients. Overall, the number of samples tested by the laboratories increased by 3% compared to the previous week.

Yellow fever – Gabon

On 15 April 2020, WHO received information regarding a confirmed case of yellow fever in Magandi village, Tchibanga city in Nyanga Province of southern Gabon, 590 km from the capital, Libreville.

The case is an 83-year-old male with no known vaccination history for yellow fever. He had onset of symptoms on 30 January 2020 and presented to a health facility on 2 February 2020 with abdominal pain and jaundice. Between 2 February and 9 April, he consulted the Urban Health Centre in Tchibanga, the Christian Alliance Hospital in Bongolo and the University hospital in the capital Libreville where the case received anti-malarial treatment and remained hospitalized until his death on 9 April 2020. On 14 April 2020, the laboratory results received from the WHO Regional Reference Laboratory at the Institute Pasteur in Dakar, Senegal, confirmed yellow fever infection, by seroneutralisation test. The additional differential diagnostic tests performed were negative for dengue, West Nile fever, chikungunya, Crimean-Congo Haemorrhagic fever, Zika and Rift Valley fever.

Ebola virus disease – Democratic Republic of the Congo

No new confirmed cases of Ebola virus disease (EVD) have been reported in Ituri, North Kivu and South Kivu Provinces of the Democratic Republic of the Congo since 27 April 2020 (Figure 1).

The source of infection of the cluster reported in April 2020 remains unconfirmed.

Yellow fever – Togo

On 20 April 2020, WHO received information regarding a confirmed yellow fever case in Galangashie health area, located 30 km from Mango village, Oti district, Savanes region in the northern part of Togo.

The case is a 55-year-old woman with no vaccination history for yellow fever. She had onset of symptoms on 31 January 2020 and presented to a health facility on 3 February 2020 with fever and aches. The following day she developed jaundice and a blood sample was taken. On 7 February , the blood sample was transported to the national laboratory. On 10 February , the sample from the case was received at the national laboratory and test results on 17 March were Immunoglobulin M (IgM) positive for yellow fever. The positive yellow fever result was confirmed by the Institute Pasteur in Dakar Senegal, a yellow fever reference laboratory on 14 April 2020 by seroneutralisation.

Ebola virus disease – Democratic Republic of the Congo

No new confirmed cases of Ebola virus disease (EVD) have been reported in Ituri, North Kivu and South Kivu Provinces of the Democratic Republic of the Congo since 27 April 2020 (Figure 1).

The source of infection of the cluster reported in April 2020 remains unconfirmed.

Ebola virus disease – Democratic Republic of the Congo

On 31 May 2020, WHO received information that between 18 and 30 May, four deaths were reported from the same quarter (quartier Air Congo) in Wangata Health Zone, Mbandaka city, Equateur Province, the Democratic Republic of the Congo.

Ebola virus disease – Democratic Republic of the Congo

From 20 to 26 May 2020, no new cases of Ebola virus disease (EVD) have been reported from the Democratic Republic of the Congo (Figure 1).

Dracunculiasis (Guinea worm disease) – Ethiopia

Between 2 and 8 April 2020, six suspected human cases of dracunculiasis in Duli village, Gog district, Gambella region, Ethiopia, were reported to WHO.

Ebola virus disease – Democratic Republic of the Congo

From 13 to 19 May 2020, no new cases of Ebola virus disease (EVD) have been reported from North Kivu Province, Democratic Republic of the Congo.

Ebola virus disease – Democratic Republic of the Congo

From 6 to 12 May 2020, no new cases of Ebola virus disease (EVD) have been reported from North Kivu Province, Democratic Republic of the Congo (Figure 1). Since the resurgence of the outbreak on 10 April 2020, seven confirmed cases have been reported from Kasanga, Malepe and Kanzulinzuli Health Areas in Beni Health Zone. Of these, one is receiving care at the Beni Ebola treatment centre (ETC), one who was receiving care at the ETC recovered and was discharged, and one remains in the community, 35 days after symptom onset. Efforts to locate this individual are being undertaken to test and provide care for this person. Four of the people confirmed to have Ebola died, including two community deaths and two deaths in the ETC in Beni. So far, no definitive source of infection has been identified.

As of 12 May, 90 contacts are currently under surveillance, of which 41 are high-risk contacts who had direct contact with body fluids of the last confirmed case. All contacts have exited their high-risk period (seven to 13 days after last exposure). Contacts from the previous six cases reported in April have exited their follow-up period. Of the 41 high-risk contacts, 37 have been vaccinated. A total of 1486 people have been vaccinated in Beni and Karisimbi since 10 April 2020.